Department of Family Medicine and the Graduate Medical Sciences Division, Boston University School of Medicine, Boston, MA, USA.
Br J Nutr. 2010 Apr;103(8):1223-9. doi: 10.1017/S0007114509992893. Epub 2009 Nov 24.
Obesity affects one in three American adult women and is associated with overall mortality and major morbidities. A composite diet index to evaluate total diet quality may better assess the complex relationship between diet and obesity, providing insights for nutrition interventions. The purpose of the present investigation was to determine whether diet quality, defined according to the previously validated Framingham nutritional risk score (FNRS), was associated with the development of overweight or obesity in women. Over 16 years, we followed 590 normal-weight women (BMI < 25 kg/m2), aged 25 to 71 years, of the Framingham Offspring and Spouse Study who presented without CVD, cancer or diabetes at baseline. The nineteen-nutrient FNRS derived from mean ranks of nutrient intakes from 3 d dietary records was used to assess nutritional risk. The outcome was development of overweight or obesity (BMI > or = 25 kg/m2) during follow-up. In a stepwise multiple logistic regression model adjusted for age, physical activity and smoking status, the FNRS was directly related to overweight or obesity (P for trend = 0.009). Women with lower diet quality (i.e. higher nutritional risk scores) were significantly more likely to become overweight or obese (OR 1.76; 95 % CI 1.16, 2.69) compared with those with higher diet quality. Diet quality, assessed using a comprehensive composite nutritional risk score, predicted development of overweight or obesity. This finding suggests that overall diet quality be considered a key component in planning and implementing programmes for obesity risk reduction and treatment recommendations.
肥胖影响了三分之一的美国成年女性，与总死亡率和主要发病率相关。一种综合饮食指数可以评估整体饮食质量，从而更好地评估饮食与肥胖之间的复杂关系，为营养干预提供依据。本研究旨在确定根据先前验证的弗雷明汉营养风险评分（FNRS）定义的饮食质量是否与女性超重或肥胖的发展有关。在超过 16 年的时间里，我们对弗雷明汉后代和配偶研究中 590 名年龄在 25 至 71 岁、BMI<25kg/m2、无 CVD、癌症或糖尿病的正常体重女性进行了随访。从 3 天饮食记录中平均排名得出的 19 种营养素 FNRS 用于评估营养风险。研究的结果是在随访期间发展为超重或肥胖（BMI≥25kg/m2）。在逐步多因素逻辑回归模型中，根据年龄、体力活动和吸烟状况进行调整后，FNRS 与超重或肥胖呈直接相关（趋势 P=0.009）。饮食质量较差（即营养风险评分较高）的女性与饮食质量较高的女性相比，更有可能发展为超重或肥胖（OR 1.76；95%CI 1.16，2.69）。使用综合复合营养风险评分评估的饮食质量预测了超重或肥胖的发展。这一发现表明，整体饮食质量应被视为规划和实施肥胖风险降低和治疗建议计划的关键组成部分。
